Efficacy of water filters for dental chair units: assessment of the filtration action versus Coxsackievirus B5.

INTRODUCTION: The microbiological safety and control of the water used in dental practice has a critical importance for avoiding cross-linked infections in the dental office. The aim of this study was to establish coxsackie virus filtration of the water applied to a dental unit. METHODS: A specific water filter-system was used, to verify the viral load in the outgoing water. The statistical analysis was performedusing the Shapiro-Wilk and t-Student test. RESULTS: The outcome of the evaluation of the virologic tests shows an excellent capability of virus filtration that attested 99.9999% in the volume analyzed. A statistical difference was found in the bacterial water contamination parameter before and after filtration. (P = 0.000000). CONCLUSIONS: According to the tests, medical devices applied to a dental unit are able to filter viruses and therefore reduce risk of contamination in the dental office.

A 10-year retrospective comparative human study on screw-retained versus cemented dental implant abutments.

The aim of this 10-year retrospective study was to evaluate the long-term reliability, survival rate and mechanical and biological complications of single-crown implant rehabilitations with two different types of fixture-abutment connections: screw-retained abutments (SRAs) with internal hexagonal connection, and cemented retained abutments (CRAs). A total of 300 single implant-supported crowns were analysed, which had been inserted between 2004 and 2007. Patients were classified according to two groups: the SRA group (n = 150) and the CRA group (n = 150). The primary outcome was marginal bone loss (MBL) on peri-apical radiographs. Bleeding on probing (BOP) and probing depth (PD) were also evaluated. Moreover, prosthetic complications were recorded. Analysis of variance (ANOVA) was used to evaluate the differences between the groups. The overall implant failure rate was 4.2%. The overall positive BOP index was 81.9% of the sites under investigation, as 83.4% for SRA and 80.4% for CRA. Moreover, >5 mm PD demonstrated a rate of 21.0% for CRA, and 13.8% for SRA. The primary outcome of mean MBL was 2.09±1.07 mm for SRA and 1.54±1.20 mm for CRA. Analysis of variance of MBL showed statistical significance for the difference between these two groups (P less than 0.001). For the mechanical aspects, an overall 12.5% of complications occurred. No implant or abutment fractures were recorded. Although complications occurred, the results from this 10-year retrospective study show that these two methods have positive long-term follow-up. With MBL significantly greater for the SRA group than the CRA group, the clinical use of CRA is encouraged in terms of the lower bone resorption rate.

A novel technique to prevent sinus membrane collapse during maxillary sinus floor augmentation without bone graft: technical note.

Different surgical techniques have been developed to reconstruct the posterior maxilla without bone graft. A barrier membrane usually placed internal to the sinus, without stabilizer or bone window, pushed inside the sinus cavity as the ''roof'' of the sinus cavity to preserve the space and help bone regeneration has been used with success. In the present technical report, the heterologous cortical lamina is used for the mechanical support of sinus membranes. The membrane is placed through two lines of 2-3 mm, mesial and distal, created at the top of the antrostomy. The half heterologous membrane is positioned on these lines and pushed to the nose wall of the sinus, and the other half is folded to cover the window. In this way the bone lamina is stable. Cone Beam Computed Tomography was used to evaluate the efficacy of bone lamina to preserve the space in sinus lifting which contributes positively to wound healing and is effective in bone formation without biomaterials.

Delayed expansion of atrophic mandible (deam): a case report.

PURPOSE: The present case report presents the clinical results of delayed expansion of mandibles by ultrasonic surgery in case of mono edentulous. MATERIALS AND METHODS: The patients with a residual alveolar ridge thickness between 2,3 and 4,1 mm in the coronal area of posterior mandible was threated. In the first stage, four linear corticotomies were carried out by ultrasonic surgical device; bone expansion was not performed. After 4 weeks, in the second stage, adequate bone expansion, without compromising cortical vascularisation, by utilising a combination of scalpel, thin chisels and threaded osteotomes was achieved and one implant was placement, after filling the gaps with a cortico bovine biomaterial. RESULTS: The postoperative course was uneventful and final width ridge was 6,17±0,26mm. CONCLUSIONS: The present case report showed that mandibular ridge expansion using a delayed split-crest technique by means of ultrasonic surgery and association with biomaterial clinically lead to a good horizontal bone gain with no fractures of the buccal plate and high implant success rate.

Mandibular third molar displaced in the sublingual space: clinical management and medicolegal considerations.

This paper describes the management of a failed mandibular third molar extraction, resulting in tooth displacement in the sublingual space, the discussion of the diagnosis, surgery and medico-legal considerations. A 28-year-old male patient underwent an unsuccessful attempt of the 4.8 tooth extraction. The clinician lost visual contact after luxation and the patient was not recalled for post-operative follow-up. After 24 hours, a severe trismus started. Ortopantomography and cone beam computer tomography revealed the displacement in the sublingual space. The tooth was removed under general anaesthesia with intraoral approach. The follow-up was uneventful and the paraesthetic area on the tongue did not enlarge after the retrieval. The displaced mandibular third molar is a rare but potentially serious complication of extraction. This event should be avoided with correct diagnosis and surgical technique. Cone beam computed tomography was useful to determine the three-dimensional position of the displaced tooth.

A cytotoxic analysis of a sardinian plant extract cream on human oral primary cell cultures: an in vitro study.

Wound healing agents support the natural healing process, reduce trauma and likelihood of secondary infections and hasten wound closure. The aim of this work was to evaluate the effect of different concentration of a new Sardinian plant cream (RD7) on two human primary cultures: Periodontal Ligament Stem Cells (hPDLSCs) and Gingival Fibroblasts (hGFs) derived from oral tissues in terms of morphological changes, cell proliferation and wound healing properties. RD7, is an interactive dressing containing phytocomplex derived from Sardinian endemic or not, medicinal plant extracts, with an important anti-radical, anti-inflammatory and antiseptic activity finalized to rapidly promote tissue regeneration and the formation of granulation tissue. hPDLSCs and hGFs were seeded at different concentrations (0.5, 1, 2.5 and 5 mg/ml) of RD7. The cell proliferation and viability was evaluated using colorimetric assays (MTT assay) and trypan blue exclusion test. Meanwhile, the morphological cell changes were evaluated by means of optic (OM) and scanning electronic microscopes (SEM). The induction of the migratory properties was evaluated by means of wound healing assay. In vitro results, using hPDLSCs and hGFs, showed a decrease of cell growth starting at 24 h of incubation, at high concentrations (2.5 mg/ml and 5 mg/ml). This cell growth reduction was associated to evident morphological changes, whilst, at low concentrations (0.5 and 1 mg/ml) a typical unchanged morphology of both hPDLSCs and hGFs was shown. Wound healing assay showed a complete wound full closure occurring after 24 h of treatment in samples treated with low concentration of RD7. The results of the present work indicate that low concentrations of RD7 have no cytotoxicity effect, stimulate cell proliferation and contribute to induce the migratory properties in hPDLSCs and hGFs, therefore it could be considered a new product for use in clinical practice.

Impact of mast cells on the skin.

When through the skin a foreign antigen enters it provokes an immune response and inflammatory reaction. Mast cells are located around small vessels that are involved in vasaldilation. They mature under the influence of local tissue to various cytokines. Human skin mast cells play an essential role in diverse physiological and pathological processes and mediate immediate hypersensitive reaction and allergic diseases. Injection of anti-IgE in the skin or other agents that directly activate mast cells may cause the decrease in vascular tone, leakage of plasma and may lead to a fall in blood pressure with fatal anaphylactic shock. Skin mast cells are also implicated as effector cells in response to multiple parasites such as Leishmania which is primarily characterized by its tissue cutaneous tropism. Activated macrophages by IFNgamma, cytotoxic T cells, activated mast cells and several cytokines are involved in the elimination of the parasites and immunoprotection. IL-33 is one of the latest cytokines involved in IgE-induced anaphylaxis and in the pathogenesis of allergic skin disorders. IL-33 has been shown in epidermis of patients with psoriasis and its skin expression causes atopic dermatitis and it is crucial for the development of this disease. Here we review the impact of mast cells on the skin.

Anti-hemorrhagic agents in oral and dental practice: an update.

Many oral surgeons in their daily practice have the problem of controlling postoperative bleeding. In surgical, oral and maxillofacial practice, standard anti-hemorrhagic protocols, especially in high risk patients, are obviously required and need to be continuously updated. The purpose of this review is to give a rational insight into the management of bleeding in oral and dental practice through modern drugs and medical devices such as lysine analogues and serine protease inhibitors, desmopressin, fibrin sealants, cyanoacrylates, gelatins, collagen and foams, protein concentrates, recombinant factors, complementary and alternative medicine and other compounds.

Mast cell involvement in rheumatoid arthritis.

Autoimmunity is a failure of self-tolerance resulting in immune reactions against autologous antigen. Rheumatoid arthritis is characterized by inflammation of synovium associated with destruction of the join cartilage and bone. A role of mast cell-mediated inflammation and antibodies are involved in this disease. Numerous cytokines such as IL-1, TNF, IL-8, IL-33 and IFN gamma have been implicated in rheumatoid arthritis and in particular in the synovial joint fluid. Since TNF is believed to activates resident synovial cells to produce collagenase that mediate destruction of cartilage, antagonists against the inflammatory cytokine TNF have a beneficial effects in this disease. Here we review the interrelationship between rheumatoid arthritis and mast cell activation.

Impact of capsaicin on mast cell inflammation.

Mast cells are inflammatory cells, and they are prominent in inflammatory diseases such as allergy and asthma. Mast cells possess high-affinity receptors for IgE (FcERI) and the cross-linking of these receptors is essential to trigger the secretion of granules containing arachidonic acid metabolism (such as prostaglandin (PG) D2, leukotriene (LT) B4, and LTC4), histamine, cytokines, chemokines, and proteases, including mast cell-specific chymases and tryptases. Activation of mast cells provokes the secretion of cytokines and mediators that are responsible for the pathologic reaction of immediate hypersensitivity. Sensory nerve stimulation by irritants and other inflammatory mediators provokes the release of neuropeptides, causing an increase in vascular permeability, plasma extravasation and edema. Trigeminal nerve stimulation actives dura mast cells and increases vascular permeability, effects inhibited by capsaicin. Capsaicin causes release of sensory neuropeptide, catecholamines and vasodilation. Several studies have reported that capsaicin is effective in relief and prevention of migraine headaches, improves digestion, helps to prevent heart disease, and lowers blood cholesterol and blood pressure levels. The findings reported in these studies may have implications for the pathophysiology and possible therapy of neuroinflammatory disorders.

Use of Oral Chroma™ in the assessment of volatile sulfur compounds in patients with fixed protheses.

Prosthetic rehabilitation improves the patient's quality of life and oral health. The purpose of the present study was to assess the production of volatile sulfur compounds (VSCs) using Oral Chroma™ in patients wearing provisional and permanent fixed prosthesis, who were treated or not, with supportive non-surgical periodontal therapy. A total of 10 healthy patients not affected by periodontal disease and who needed the restoration of at least two edentulous single sites were included in the present study. Registrations of VSCs were carried out with a Gas Chromatograph OralChroma™ (Oral Chroma™, Abimedical, Abilit Corp., Osaka, Japan) one month after placement of the provisional restoration (group 1) and one month after placement of the final restoration (group 3). After each measurement, professional oral hygiene was carried out both on patients with provisional (group 2) and permanent prostheses (group 4) and VSC values were registered. The results showed that there were no statistical significant differences in the VSC quantity between groups with temporary or permanent prostheses. Meanwhile, statistically significant differences were found in VCS values between groups before and after the professional health care session (p less than 0.05). Also it was observed that dimethyl sulphide (CH3)2S was present in all the study groups. The present preliminary study suggests that OralChroma™ produce a comprehensive assessment of VSC in the clinical diagnosis of halitosis and that professional oral hygiene seems to influence VSC production. However, further clinical long-term studies with a larger sample size are necessary for a better understanding of halitosis manifestation in patients wearing provisional and permanent fixed prosthesis.

Role of vitamins D, E and C in immunity and inflammation.

Inflammatory responses are operationally characterized by pain, redness, heat and swelling at the site of infection and trauma. Mast cells reside near small blood vessels and, when activated, release potent mediators involved in allergy and inflammation. Vitamin D modulates contraction, inflammation and remodeling tissue. Vitamin D deficiency has been linked to multiple diseases and several data have demonstrated a strong relationship between serum vitamin D levels and tissue function. Therapy targeting vitamin D3 signaling may provide new approaches for infectious and inflammatory skin diseases by affecting both innate and adaptive immune functions. Mast cells are activated by oxidized lipoproteins, resulting in increased expression of inflammatory cytokines and suggesting that the reduction of oxidation of low density lipoprotein by vitamin E may also reduce mast cell activation. Vitamin C is also an anti-oxidant well-known as an anti-scurvy agent in humans. Vitamin C inhibits peroxidation of membrane phospholipids and acts as a scavenger of free radicals and is also required for the synthesis of several hormones and neurotransmitters. In humans, vitamin C reduces the duration of common cold symptoms, even if its effect is not clear. Supplementation of vitamin C improves the function of the human immune system, such as antimicrobial and natural killer cell activities, lymphocyte proliferation, chemotaxis and delayed-type hypersensitivity. Vitamin C depletion has been correlated with histaminemia which has been shown to damage endothelial-dependent vasodilation. However, the impact of these vitamins on allergy and inflammation is still not well understood.

Vascular endothelial growth factor (VEGF), mast cells and inflammation.

Vascular endothelial growth factor (VEGF) is one of the most important inducers of angiogenesis, therefore blocking angiogenesis has led to great promise in the treatment of various cancers and inflammatory diseases. VEGF, expressed in response to soluble mediators such as cytokines and growth factors, is important in the physiological development of blood vessels as well as development of vessels in tumors. In cancer patients VEGF levels are increased, and the expression of VEGF is associated with poor prognosis in diseases. VEGF is a mediator of angiogenesis and inflammation which are closely integrated processes in a number of physiological and pathological conditions including obesity, psoriasis, autoimmune diseases and tumor. Mast cells can be activated by anti-IgE to release potent mediators of inflammation and can also respond to bacterial or viral antigens, cytokines, growth factors and hormones, leading to differential release of distinct mediators without degranulation. Substance P strongly induces VEGF in mast cells, and IL-33 contributes to the stimulation and release of VEGF in human mast cells in a dose-dependent manner and acts synergistically in combination with Substance P. Here we report a strong link between VEGF and mast cells and we depict their role in inflammation and immunity.

Comparison of beneficial actions of non-steroidal anti-inflammatory drugs to flavonoids.

Inflammation is involved in increasing number of diseases necessitating the development of new, effective and safe treatments. Non steroidal anti-inflammatory drugs (NSAIDs) have been helpful in many instances, but they only inhibit cyclooxygenase (COX), but not the generation or actions of cytokines. Instead, some natural flavonoids have multiple anti-inflammatory effects, including COX inhibition, and a much safer profile. Increasing evidence indicates that inflammation plays a critical role in the pathogenesis of many diseases that also involve mast cells. Consequently, the need for new, effective and safe anti-inflammatory drugs is all the more urgent. Corticosteroids are quite potent, but have many adverse effects such as increased risk of infections, osteoporosis, glaucoma and depression. Biological agents such anti-TNF are useful in certain conditions, such as rheumatoid arthritis and psoriasis, but has been associated with increased risk of infection and leukemia.

IL-36 receptor antagonist with special emphasis on IL-38.

IL-36 is another family member of IL-1 and induces the production of proinflammatory cytokines and activates MAPK and NFkB pathways. IL-36 is a common mediator of innate and adaptive immune response and is inhibited by IL-36 receptor antagonist (RA). IL-36RA acts on IL-36 receptor ligand which exerts proinflammatory effect in vivo and in vitro. IL-38 binds to IL-36 receptor as does IL-36RA and has similar biological effects on immune cells. IL-38 is also a member of IL-1 cytokine and shares some characteristics of IL-1RA, binding the same IL-1 receptor type I. IL-38 plays a role in the pathogenesis of inflammatory diseases, exerting protective effect in some autoimmune diseases. Both IL-38 and IL-36RA have an anti-inflammatory biological effect, however in some cases have contrary effects.

Luteolin inhibits mast cell-mediated allergic inflammation.

Mast cells are ubiquitous in the body and multifunctional immune cells; they are known to be primary responders in allergic reactions, orchestrating strong responses to minute amounts of allergens. Mature mast cells perform important beneficial roles in host defense, both in IgE-dependent immune responses to certain parasites and in natural immunity to bacterial infection. In IgE-associated biological responses, the crosslinking of FcεRI-bound IgE with multivalent antigens initiate the activation of mast cells by promoting aggregation of FceRI. This cross-linking receptor-bound IgE by multivalent Ag initiates a cascade of intracellular reactions leading to mediator release such as proinflammatory mediators, chemokines and cytokines. Luteolin belongs to a flavone group of compounds called flavonoids, it has anti-oxidant properties, inhibits some cancer cell proliferation and exerts a regulatory effect on mast cell-mediated inflammatory diseases and allergy. Here we report the impact of luteolin on mast cell activation.

Copper-zinc superoxide dismutase activity in dental pulp after dental preparation.

The superoxide dismutases (SODs) are the major enzymatic defence mechanism against toxic reactive oxygen species generated during normal oxidative metabolism and during the respiratory burst associated with inflammation. To further clarify the potential role of copper-zinc (Cu/Zn)-SOD during inflammation of pulp tissue in humans, the aim was to determine whether significant changes in Cu/Zn-SOD activity occur in healthy dental pulp after dental preparation. The condition of the pulp was assessed using clinical and radiographic evaluation. Thirty systemically healthy patients were the source of the pulp tissue, which was collected by longitudinally grooving and splitting teeth that were matched between the control dental pulp and the prepared tooth (test) dental pulp. Cu/Zn-SOD activity was determined through spectrophotometric methods, with Mann-Whitney tests used to assess the significance of the differences between the groups. The Cu/Zn-SOD activity was 168.2+/-46.4 mU.mg−1 total protein (range: 96-212 mU.mg−1) in the control group, and 328.2+/-84.2 mU.mg−1 total protein (range: 280-420 mU.mg−1) in the test group. The difference between the groups was statistically significant, at P <0.001. These results demonstrate a potential role for Cu/Zn-SOD during dental pulp inflammation in humans after dental preparation.

Two-step impression/ injection, an alternative putty/ wash impression technique: case report.

We here describe a new technique for making a definitive impression that we refer to as the two-step impression/injection technique. This technique initially follows the classical one-step putty/ light-body impression technique with the polymerization of the putty and the light-body compound. This is then followed by the second step: injection of extra-light-body compound into the preparation through a hole in the metal stock tray. The aim of this additional step is to control the wash bulk and minimize the changes that can produce unfavorable impression results. This new two-step impression/injection technique allows displacement of soft tissues, such as the tongue, during the first seating of the putty and wash materials, while in the second step, the extra-light-body compound records all of the finer details without being compressed.

Comparison of the primary stabilities of conical and cylindrical endosseous dental implants: an in-vitro study.

The aim of this study is to determine the differences in primary stability between conical and cylindrical dental implants. The insertion and removal torques were the parameters used to measure the primary stability of the implants. Ten conical and cylindrical dental implants were positioned in polyurethane foam blocks to simulate bone density classes D1, D2, D3 and D4. The insertion and removal torques were quantified using a digital torque gauge. The maximum insertion torque and the maximum removal torque measured for the D1 and D4 synthetic bone were significantly higher for the conical implants than the cylindrical implants. In this in-vitro model, conical implants show significantly higher primary stability than cylindrical implants for the D1 and D4 synthetic bone classes.